Tratamento de paciente Classe II com mini-implante: relato de caso / Patient treatment of Class II with mini-implant: case report

Dentre as anomalias dentárias tratadas pelos ortodontistas, a Classe II tem grande prevalência. Aspectos importantes no seu diagnóstico e planos de tratamentos devem ser considerados, idade, severidade e colaboração do paciente. Vários mecanismos de distalização de molares são descritos na literatura, o aparelho extrabucal, elásticos intermaxilares e distalizadores intrabucais. O uso de mini-implante tem sido um importante auxiliar na distalização de molares. Este artigo relatou um caso clínico detalhando os passos para instalação, procedimentos cirúrgicos, indicações, cuidados com a higiene e complicações mais frequentes na utilização de mini-implantes. Foi utilizado um mini-implante na região entre pré-molar e molar, e os resultados foram satisfatórios com finalização dentro dos padrões de normalidade ortodôntica.(AU)

Among the dental anomalies treated by orthodontists, the Class II has a high prevalence.Important aspects in the diagnosis and treatment plans should be considered, age, severity and cooperation of the patient. Several features, mechanical distal movement of molars are described in the literature, including the headgear, intermaxillary elastics and intraoral distalization. The use of mini-implants has been an important aid in the distal movement of molars. In this article we seek to report a case detailing the steps for installation, surgical procedures, indications, care with hygiene and more frequent complications in the use of mini-implants. A mini-implant was used in the region between premolar and molar, and the results were satisfactory with a submission within the orthodontic normal standards.(AU)

Class II, Division 1 Angle malocclusion with severe proclination of maxillary incisors

Protrusion of maxillary incisors is a common complaint among patients seeking orthodontic treatment. This report addresses the correction of Class II Angle malocclusion with excessively bucally proclined maxillary incisors, in an adolescent female patient, through the use of extraoral and fixed appliances. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements for obtaining the title of certified by the BBO.

A protrusão dos incisivos superiores é uma queixa frequente nos pacientes que buscam o tratamento ortodôntico. O presente relato aborda a correção de uma má oclusão de Classe II de Angle, com severa protrusão e inclinação para vestibular dos incisivos superiores, em uma paciente adolescente do sexo feminino, por meio do uso de aparelhagem extrabucal e fixa. Esse caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do título de Diplomada pelo BBO.

Distalización con el C-DFD modificado con mini-tornillos. Reporte de caso / Distalization with a C-DFD modified with mini-screws. A case report

En la actualidad existen muchos dispositivos para distalizar los molares cuando se presenta una maloclusión clase II; como son la tracción extraoral, el péndulo dento y óseosoprtado, el distal jet, sliding jig entre otros. Todos con efectos secundarios indeseables. Este reporte de caso pretende ilustrar los resultados obtenidos con un dispositivo con anclaje cortical y óseo en una maloclusión clase II. Reporte de caso clínico en un paciente clase II esquelético y dental. Se usó un aparato de anclaje cortical, diseñado en la Universidad CES de Medellín, llamado Cortical Dual Forcé Distalizer (C-DFD), el cual fue modificado con un par de mini-tornillos para reforzar el anclaje, logrando la distalización superior de los molares evitando un tratamiento con exodoncias. El C-DFD es un distalizador óseo-soportado que logra un movimiento distal del primer molar superior.

There are currently many devices used for molar distalization when there is a Class II malocclusion; some of these devices include headgear, tooth-supported and bone-supported pendulums, the distal jet, and the sliding jig, among others. All of them have undesirable side effects. This case report aims to illustrate the results obtained by using a device with cortical and bone anchorage to treat a Class II malocclusion of a patient with a skeletal and dental class II malocclusion. A Cortical Dual Forcé Distalizer (C-DFD, a cortical-anchoring appliance designed at CES University in Medellín, Colombia was used. This device was modified by using a couple of mini-screws to reinforce anchorage, thus achieving upper distalization of molars and avoiding treatment with extractions. The C-DFD is a bone-supported distalizer that achieves a more controlled and in-body distal movement of the first upper molar, avoiding the inclinations produced by other distalizers.

Changes of the upper lip in orthodontic and orthopedic treatment of angle's class II malocclusion.

Aims: This study aimed to evaluate the changes in upper lips due to incisors retraction in Class II Division 1 patients treated with mandibular protraction, fixed appliances, and without extraction. Materials and Methods: The sample consisted of 64 pre- and post-treatment lateral cephalometric X-rays of 32 patients with 9-12 years old (16 men and 16 women), who presented ANB > 4 o , overjet ≥ 4 mm, treated with Balter's Bionator and fixed appliances. The average period between initial and final radiographies was 5 years (maximum of 5.5 years and minimum of 4.5 years). Statistical Analysis Used: A Student's t-test (P < 0.01) evaluated the statistical significance of differences between the mean values obtained for pre- and post-treatment in each variable, for males and females. Linear regression analysis for hard-tissue variables in relation to soft-tissue variables were also made for correlation. Results: The male group presented cervical point with r = 0.40 and incisal point with r = 0.42. Female subjects showed incisor cervical point with r = 0.86 and incisal point r = 0.74. The average Ls retraction was 0.55 mm in 2.43 mm of incisal point movement and 0.34 mm of cervical point. The nasolabial angle showed increase average of 2° for men and 3.9° for women. Conclusion: There is a difference between genders regarding the lip-incisor relation at this age. Males presented thickening of soft tissue and week correlation between the movement of the incisor and soft tissue both cervical and incisal point. In females' subjects, a strong correlation between the retraction movement and soft tissue, both cervical and incisal point.